community mental health and wellbeing: what we learnt from

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Community mental health and wellbeing: What we learnt from COVID-19

Executive Summary July 2021

Community mental health and wellbeing: What we learnt from COVID-19 – Executive Summary

Mental Health Commission of NSW of 12

Table of contents

Overview ............................................................................................................................................. 3

1.1 Mental health and wellbeing lessons from COVID-19 .......................................................... 3

1.2 Study methodology ............................................................................................................... 3

1.3 Key findings .......................................................................................................................... 3

2. Impact on NSW residents ........................................................................................................... 4

2.1 Overall, COVID-19 had a negative impact on NSW residents; however, some people reported a positive impact.................................................................................................... 4

2.2 Positive feelings about life fell during 2020 ......................................................................... 4

2.3 One in 10 NSW residents experienced a new mental health issue during 2020 ................. 5

2.4 Younger and middle-aged adults were more vulnerable to mental health, social and economic impacts of COVID-19 ............................................................................................ 5

2.5 A range of emotional and psychological impacts was experienced – both positive and negative ......................................................................................................................... 7

2.6 Nearly all NSW residents could identify positive lessons they had learnt from COVID-19 .... 7

3. Responding to COVID-19 and opportunities for the future ............................................................. 8

3.1 Approximately one in two people accessed some type of formal or informal support during 2020 ......................................................................................................................... 8

3.2 Formal or informal support appears to be linked to a more positive experience during 2020 for those with a pre-existing mental health issue ............................................ 8

3.3 Cautious but increasing level of optimism about the future ................................................. 9

3.4 Services through GPs, online advice about typical issues, and guidance for supporting young people were the top choices for supporting mental health post-COVID .................. 10

3.5 Generational change in acceptance and recognition of mental health issues .................. 10

4. Appendix ................................................................................................................................. 11

4.1 Survey participants: demographics and characteristics .................................................... 11

The Mental Health Commission of New South Wales (the Commission) was established in July 2012. The Commission’s purpose is to monitor, review and improve the mental health and wellbeing of the community by undertaking strategic

planning, systemic reviews and advocacy - all guided by the lived experience of people with mental health issues and caring, families and kinship groups.

The vision of the Commission is:

That the people of NSW have the best opportunity for good mental health and wellbeing and to live well in the community, on their own terms, having the services and supports they need to live a full life.

Mental Health Commission of NSW (2021). Community mental health and wellbeing: what we learnt from COVID-19 – Executive Summary © State of NSW 2020 ISBN: 978-0-6488428-7-3 nswmentalhealthcommission.com.au



Overview

1.1 Mental health and wellbeing lessons from COVID-19 The COVID-19 pandemic has forced every Australian to view their world differently. It has touched every area of life; affecting personal freedoms, relationships with family and friends, engagement with work, study or other important activities, and financial well-being and mental health.

Since the start of the global pandemic in 2020, we have been forced to develop strategies to deal with these changes. Many of these strategies have developed organically from people finding the best way they can continue to live their lives and manage their relationships in the face of health risks and restrictions. These changes and strategies have had an impact on the mental well-being of all Australians. For some, this may have been more complex because of underlying mental health issues – previously recognised or emerging.

To better understand the mental health implications and health and social consequences of COVID-19, the Mental Health Commission of NSW (the Commission) engaged Review Partners to develop and conduct the NSW COVID-19 Community Wellbeing Survey. The aim of the survey was to:

• Investigate the impact of COVID-19 on the health and wellbeing of NSW residents and those with lived experience of mental health issues.

• Evaluate how NSW residents have responded to the pandemic. • Identify lessons and expectations of the future that will be important for charting community recovery.

1.2 Study methodology A 15-minute online survey was run during December 2020 to January 2021 to survey 2000 people (aged 18 and above) who represented the adult population of NSW. Participant quotas were set according to the ABS census profile statistics for NSW on age, gender and location (capital city vs regional NSW) and minor variations were corrected with statistical weighting.

People with lived experience of mental health issues and caring, families and kinship groups, people from diverse backgrounds were also encouraged to participate via survey promotion by the Commission and its partner organisations. These responses added to the number of people who reported a lived experience of a mental health issue and were included in the weighting against the statistics for the NSW population. In the final sample of 2000 people, 374 (19%) reported either a pre-existing mental health issue in 2018-19 (i.e., pre-COVID-19) or a new issue in 2020. This provided a statistically valid sample to compare the experience of those with a lived experience of a mental health issue versus the experience of the overall NSW population. Our approach differs from the common sampling method that has been used in COVID-19 and mental health studies that rely on self-selection samples. By using a statically weighted representative sample, we can discuss the results in the context of the NSW general adult population.

1.3 Key findings Overall, the results demonstrated the polarising impacts of COVID-19 with a considerable proportion of the population experiencing both positive and negative impacts across all areas of their life. Age was significantly associated with how COVID-19 has impacted people’s lives. Younger adults (18-29 year olds) felt more negative impacts on their relationships, health, work/study, and finances, compared to older people. About one in two people accessed some type of formal or informal support during 2020 and it is recognised that a range of services will continue to be needed to support NSW’s recovery from the impacts of the pandemic. Services through GPs, online advice about typical mental health issues, and guidance for supporting young people were the top preferences to ensure that mental health is supported post-COVID.

The full report with the relevant data and charts can be downloaded from the Mental Health Commission of NSW’s website. References to the full report are made throughout this executive summary for you to explore the results in more detail.

http://www.nswmentalhealthcommission.com.au/reports

http://www.nswmentalhealthcommission.com.au/reports



2. Impact on NSW residents

2.1 Overall, COVID-19 had a negative impact on NSW residents’ lifestyle and wellbeing; however, some people reported a positive impact

It is difficult to generalise the impact of COVID-19 on the population of NSW because residents experienced a wide range of responses to the restrictions and the perceived health threat. Participants’ responses ranged from very negative to very positive, including a proportion who reported no real change during 2020 (see Figure 1).

Overall, when asked about their ‘way of life’, a majority of 69% reported a negative overall impact. Considering their health, just under half (46%) said their overall health had been negatively impacted, while just over half (55%), reported that 2020 had a negative impact on their mental health. On the other hand, some people reported no real change or positive impacts during 2020, including 17% who said COVID-19 had no impact and 14% who claimed a positive impact on their way of life.

Figure 1. Proportion of people who reported either a positive, negative, or no real impact of COVID-19 on different areas of their life.

2.2 Positive feelings about life fell during 2020 The study asked a range of questions to explore the effect that COVID-19 was having on the mental health of NSW residents. One simple question asked participants to describe their overall feelings about life before COVID-19, in 2018-19 and then during 2020.

Overall, NSW residents felt less positive about life during 2020 than they had in the previous two years (pre-COVID). Average positive feelings about life fell by 11 percentage points from 73% positive before 2020 but only 62% positive during 2020.

While the trend was consistent across age groups, older people tended to feel more positive than younger people before and during 2020 (see page 49 of the full report).

Figure 2. Proportion of people who reported feeling positive about life before and then during COVID-19.



2.3 One in 10 NSW residents experienced a new mental health issue during 2020

To identify those with a lived experience of a mental health issue, participants were asked:

“Thinking back to the previous two years (2018-19) … and … thinking about 2020, were you advised by a health professional/mental health professional that you had a mental health issue?”

In response, 19% of residents reported mental health issue(s) between 2018 and 2020.

When broken down by time period, those reporting experience of a mental health issue between 2018 and 2019 represented 16% of the NSW population. Since the onset of COVID-19, 9% of NSW residents with no prior mental health problems reported that they were experiencing a new mental health issue as advised by a mental health professional. Around 6% reported both a pre-existing mental health issue AND a new issue in 2020.

Depression and anxiety disorders continue to be the most common mental health issue (both before and during 2020). Other issues reported less frequently were bipolar disorder and a psychosis, such as schizophrenia (see page 5 of the full report).

A higher incidence of mental health issues was reported among:

• Younger NSW residents • Households with children • Those born in Australia • LGBTQ+ residents • Aboriginal and Torres Strait Islander residents (see page 17 of the full report for details).

2.4 Younger and middle-aged adults were more vulnerable to mental health, social and economic impacts of COVID-19

While the elderly were most vulnerable to the physical effects of COVID-19, it was 18-39 years olds who were most vulnerable to negative impacts on their lives overall, and their mental health in particular.

During 2020, younger adults (18-29 year olds) were more likely than older people to report a negative impact of COVID-19 on a range of measures considered in the study, including:

• Their mental health and overall health (Figure 4 and 5). • Specific financial and practical impacts, like losing a job or running out of money (Figure 6). • Their relationships and feeling connected with others (Figure 7).

Most NSW residents were less connected with each other during 2020, particularly with their friends, elderly relatives and the local community. However, those aged 18-49 years old felt the greatest decline in connections, reporting more areas where they felt less connected compared to the other age groups (see page 28 of the full report).

Figure 3. Proportion of people reporting an existing and new mental health issue.



Figure 4. Impact of COVID-19 on mental health, by age. Figure 5. Impact of COVID-19 on physical health, by age.

Figure 6. Proportion of people reporting any practical or financial changes, by age.

Figure 7. Proportion of people reporting any personal or relationship changes, by age.



2.5 A range of emotional and psychological impacts was experienced – both positive and negative

In addition to the incidence of clinical diagnoses reported by participants, the survey explored the extent to which NSW residents experienced a range of broader positive and negative psychological impacts from COVID-19.

Three out of four residents (77%) experienced one or more negative impacts, while half the population (50%) reported one or more positive impacts (see page 45 of the full report). The most common reported impacts were:

2.6 Nearly all NSW residents could identify positive lessons they had learnt from COVID-19

Despite this negative impact, virtually all NSW residents (94%) could identify at least one positive lesson they had learnt from COVID-19 and related events (see Figure 8).

Similar levels of positive benefits were reported across all age groups. However, those in the cities were more likely than their rural counterparts to identify positive lessons they could adopt for the future (see page 58 of the full report).

Figure 8. Top positive lessons that people had learnt from COVID-19 that could be adopted for the future.



3. Responding to COVID-19 and opportunities for the future

3.1 Approximately one in two people accessed some type of formal or informal support during 2020

Participants were asked to identify formal or informal sources of support used to help them deal with COVID-19 and related events. Approximately half the population (49%) accessed some type of formal or informal support or activity during 2020 – that is, seeking informal support among friends and family or community groups or formal support through clinical or mental health support groups. The most common sources of formal and informal support accessed during 2020 were:

There were substantially higher levels of support utilised among different population groups, including younger people and those reporting a mental health issue. At least one source of support was accessed by:

• 66% of 18-29 year olds. • 75% of those with a pre-COVID mental health issue. • 87% of those with a new mental health issue.

3.2 Formal or informal support appears to be linked to a more positive experience during 2020 for those with a pre-existing mental health issue

Among those with a pre-existing mental health issue (n=315), those who reported taking advantage of one or more sources of support were far more likely to report a positive impact during 2020 than those who did not report accessing any form of support (see page 64 of the full report).

For example, of those who saw a psychologist or psychiatrist, 60% reported a positive impact during 2020 compared with 32% who reported no impact and 45% reporting a negative impact. This trend appears among those who accessed every other form of support. That is more people with a pre-existing mental health issue who accessed support were among the 26% of people who reported a positive impact from COVID 19 (see Figure 9).

However, of those that said they accessed ‘none of these’, a larger proportion of this group also reported that COVID had a negative (28%) or neutral (38%) impact on their pre-existing mental health issue than positive impact (8%).



Figure 9. Use of support services among those with pre-COVID mental health issues, organised by whether they reported positive, negative, or no impact on their pre-COVID mental health issue(s).

3.3 Cautious but increasing level of optimism about the future At the end of 2020, NSW residents were still experiencing a wide and varying range of restrictions as the public health advice remained in a state of change about gatherings, mask wearing and movement within the state and across borders.

Even though a vaccine was still not certain, the sense of optimism about the future grew among the general population as people looked further into the future (see page 54 of the full report).

However, optimism about their lives by the end of 2021 tended to be lowest among 18-29 year olds and those with experience of a mental health issue. Among those with a lived experience of a mental health issue, 57% of those with a pre-COVID issue felt optimistic about how life would be by the end of 2021 and 62% of those experiencing a new mental health issue in 2020 felt the same way, compared to the general NSW population at 67% (see Figure 10).

Figure 10. Proportion of people who were optimistic about life in general in 2021.



3.4 Services through GPs, online advice about typical issues, and guidance for supporting young people were the top choices for supporting mental health post-COVID

There was general agreement that a range of mental health support services will be needed until Australia returns to a post-COVID normal.

When respondents were asked to choose between six potential future mental health services, three options consistently featured in the top three for all age groups. These were:

However, it seems that young people (18-29 year olds) ranked ‘easy to find online advice about what typical mental health issues feel like and how to reach out for help’ and ‘easy to find support for parents and young people on what to do when a young person is first experiencing a mental health issue, worry or concern’ above accessing GP services (see page 66 of the full report).

3.5 Generational change in acceptance and recognition of mental health issues

Finally, the survey asked about what words people usually used to describe how they are feeling, mentally and emotionally. Overall, “my feelings” and “my state of mind” was ranked the highest with 61% and 52%, respectively, of residents preferring these terms (see page 69 of the full report).

However, the results show that there is a generational difference in the recognition of mental health and wellbeing as important and accepted terms. While older people preferred “my feelings” and “my state of mind”, younger age groups tended towards “my mental health” and “my mental wellbeing” (see Figure 11).

Figure 11. Preferred use of “my mental health” and “my mental wellbeing”, by age.



4. Appendix

4.1 Survey participants: demographics and characteristics Samples sizes are weighted to match ABS Population Statistics for NSW on age, gender and location. Minor variations were corrected with statistical weighting.

Table 1. Demographics % No. Total 100% 2000 Age 18-29 yrs 22% 426

30-39 yrs 19% 372 40-49 yrs 17% 318 50-59 yrs 16% 336 60-69 yrs 14% 287 70+ yrs 13% 261

Gender Male 49% 975 Female 50% 1022

Location Sydney Greater Metro 70% 1376 Rural or regional 30% 624

Children Children in household 41% 812 No children in household 59% 1188

Aboriginality Aboriginal or Torres Strait Islander 5% 108 Non-Aboriginal or Torres Strait Islander 95% 1892

Country of birth Australia 68% 1361 Not Australia 32% 639

Sexual orientation Straight (heterosexual) 90% 1803 LGBTQ+ 8% 153 Prefer not to answer 2% 44

Table 2. Experience of mental health issue(s), as advised by a healthcare or mental health professional

% No.

Total 100% 2000 No mental health issue(s) 81% 1626 Reported mental health issue(s)

Pre-COVID (in 2018-19) 16% 315 New (in 2020) 9% 182 Pre-COVID and New 6% 123 Pre-COVID or New 19% 374

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entalhealthcomm

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Mental Health Commission of NSW (2021).


© State of NSW 2021 ISBN: 978-0-6488428-7-3

nswmentalhealthcommission.com.au

community mental health and wellbeing: what we learnt from

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